Forty percent of adults with type 2 diabetes (T2DM) report disease-related psychological distress. The cultivation of mindfulness through Mindfulness Based Stress Reduction (MBSR) has been shown to improve emotional distress in a variety of chronic diseases; however, this promising mind body therapy has not been rigorously tested in patients with T2DM. During this mentored career development proposal, Dr. Young will enhance her prior training in epidemiology and endocrinology by pursuing a practical, hands-on research experience. She will develop an expertise In the utilization of mind-body therapies in research through active participation in seminars, academic retreats and completion of a two-year Integrative medicine fellowship. The overarching hypothesis guiding this proposal is that modulation of the stress reaction through training in mindfulness meditation will lead to Improvements In physiologic and psychological outcomes in patients with T2DM. Dr Young Is proposing a randomized, clinical trial evaluating the Impact of the standard 8-week MBSR program, compared to a health education control, on glucose metabolism, blood pressure, diabetes- related distress and quality of life in adults with T2DM who have moderate to severe levels of diabetes- related emotional distress. Additionally, she will investigate the role of neuroendocrine dysfunction, systemic inflammation and diabetes self-care practices as mediators in the relationship between increased stress, adverse glucose metabolism and elevated blood pressure. The combination of an outstanding mentoring team, highly supportive research atmosphere, inter-disciplinary training, thoughtfully designed training strategy and novel research plan provides an optimal setting for Dr. Young to pursue her long-term career goal of becoming a successful, independent, physician-scientist examining the utility of mind-body therapies as adjunctive treatments to current medical care in patients with diabetes and obesity. PUBLIC HEALTH RELEVANCE: Given its potential to foster the development of self-reliance, improved coping skills and healthier lifestyles, mindfulness meditation may be beneficial for patients with T2DM who are unable to manage the stress that accompanies living with this disease. If proven to be safe and efficacious, health care providers will have an important tool at their disposal in the fight to decrease morbidity and mortality in patients with T2DM.